| Japanese |
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| Title | 肥大型心筋症における左室局所での収縮動態 - 心電図同期99mTc-MIBI心筋断層像による検討 - |
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| Subtitle | 原著 |
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| Authors | 成田充啓*, 栗原正*, 新藤高士*, 宇佐美暢久*, 本田稔** |
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| Organization | *住友病院内科, **アイソトープ検査部 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 6 |
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| Page | 617-628 |
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| Year/Month | 1996/6 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」 肥大型心筋症 (HCM) における左室各部での収縮動態を検討するため, HCM, 健常例を対象に安静時に99mTc-MIBI心電図同期心筋断層像 (G-SPECT) を撮像した. 左室を17の区域に区分し, 各区域での収縮に伴うカウントの変化率 (%CC), 症例毎の17区域でのピークカウント出現時間のずれ (SD) を求めた. %CCはHCM全例で2区域以上に低下を見, HCM区域の47%で低下を示した. SDはHCMにおいて健常例より有意に大であった. HCMの各症例での%CCの低下区域数は123I-BMIPPのglobalな取り込み (r=-0.79), 取り込み低下区域数 (r=0.88) と有意な相関を示した. SDは心プールイメージングで求めた拡張早期1/3での左室充満速度とr=-0.66の有意な相関を示した. HCMを運動負荷で左室駆出率 (EF) が上昇した群, 低下した群に2群すると, 低下群では上昇群に比しSDが大であった. %CC低下域と%CC正常域ではR・ピークカウント時間の分布に差を見た. G-SPECTから求めた左室収縮動態の指標はHCMの病態評価に有用であると考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | ECG-gated myocardial SPECT, Hypertrophic cardiomyopathy, 123I-BMIPP myocardial imaging, Percent count change, R-Peak count interval. |
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| English |
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| Title | Regional Left Ventricular Contraction Kinetics in Patients with Hypertrophic Cardiomyopathy : Investigation by ECG-Gated Myocardial SPECT with 99mTc-MIBI |
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| Subtitle | |
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| Authors | Michihiro NARITA*, Tadashi KURIHARA*, Takashi SHINDOH*, Masahisa USAMI*, Minoru HONDA** |
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| Authors(kana) | |
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| Organization | *Department of Internal Medicine, Sumitomo Hospital, **Department of Nuclear Medicine, Sumitomo Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 6 |
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| Page | 617-628 |
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| Year/Month | 1996/6 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | To investigate the regional left ventricular (LV) contraction kinetics in patients with hypertrophic cardiomyopathy (HCM), we performed ECG gated myocardial tomography (gated-SPECT) with 99mTc methoxy-2-isobutyl isonitrile (MIBI) at rest in 11 patients with HCM and 13 normal subjects. In order to evaluate regional LV contraction kinetics, multi-plane long axial tomograms were constructed and LV was divided into 17 segments. From the time activity curve of myocardial count, percent change during systole (%CC) was calculated in each segment. Normal range of %CC in each segment was derived from normal files. Systolic asynchrony in each patient was expressed as SD (standard deviation) of R-wave to peak count (R-PC) intervals of 17 segments. Decreased %CC was observed in 87 of 187 segments (47%) in HCM (8+-5 segments / patient, range ; 2-14 segments / patient). SD in patients with HCM was significantly greater than that in normal subjects (5.9+-1.3 vs. 3.5+-0.6, p<0.01). The extent of decreased %CC in patients with HCM correlated well with global 123I-BMIPP (BMIPP) uptake and the extent of regional abnormality of BMIPP (Defect Score)(r=-0.79, r=0.88 each, p<0.01). On the other hand, SD correlated well with left ventricular (LV) filling rate during early diastole (r=-0.66, p<0.01). Patients with HCM were divided into 2 groups whether LV ejection fraction (EF) increased (Group 1) or decreased (Group 2) by exercise stress. SD in Group 2 was significantly greater than that in Group 1. In segments with decreased %CC, the distribution of R-PC interval was different with that in segments with normal %CC. These results suggested that indexes which were derived from gated-SPECT with MIBI could bring several informations which were important to assess the pathologic condition of HCM. |
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| Practice | Clinical medicine |
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| Keywords | ECG-gated myocardial SPECT, Hypertrophic cardiomyopathy, 123I-BMIPP myocardial imaging, Percent count change, R-Peak count interval. |
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